Centers of Excellence Key to Avoiding Costly Misdiagnoses

You go to your doctor after suffering for a while from widespread muscle and joint pain. The doctor refers you to a specialist, who determines that you have chronic fatigue syndrome, and orders a sleep study, thyroid check and stress test.

After all these tests, he concludes that with proper rest and self care, the problems should fix themselves in due time.

They don’t. Because in reality, you have fibromyalgia, and the misdiagnosis will end up costing you weeks of productivity at work (including a number of sick days), and a whole bunch more money in follow-up visits.

Sure, the doctor missed the diagnosis. But you’re stuck with the bill.

Sound like a nightmare scenario? It is, and it’s not that rare, either.

In 2008, the Pittsburgh Tribune-Review published findings from a four-month investigation that revealed hundreds of patients each year undergo liver transplants when they don’t need them, and that 10 percent of those patients die “when they could’ve lived longer without the transplant.”

So what’s the cost?

Emerick shares:

“In any given year about 20 percent of the outlier group have been completely misdiagnosed. They do not have the disease they’re being treated for. This means that about 16 percent of plan dollars are being wasted on outliers who have been misdiagnosed. This is a big deal. About 40 percent of the outliers have completely erroneous treatment plans or treatment plans that are clearly sub-optimal. This means that about 32 percent of plan dollars are being wasted in total. Another result is a huge amount of medical harm to the outlier population.”

Our approach at Captiva Benefit Solutions is that of the Health Rosetta, which is to immediately connect our outliers to top-notch centers of excellence, in order to get the diagnoses right the first time, and to, if necessary, have them receive necessary procedures right away. This allows for the patients to receive the best care, which is less expensive in the long run and restores the patient to health faster. It’s good for morale, productivity and the budget.

If you want to discover how this approach can work for your company (and your employees) without negatively affecting your bottom line in the end, give Captiva Benefit Solutions a call.